As vaping spreads, so do efforts to raise age for tobacco products

Jessica Wehrman Dispatch Washington Bureau @JessicaWehrman

Saturday

May 11, 2019 at 8:49 PMMay 12, 2019 at 11:52 AM

WASHINGTON — When Ohio Gov. Mike DeWine announced his plan last month to raise the state tobacco age to 21 as part of his state budget proposal, he joined what has become a critical mass of states and localities trying to stem an epidemic of underage e-cigarette use.

The numbers are shocking: Between 2017 and 2018 alone, e–cigarette used increased 78 percent among high school students and 48 percent among middle school students, according to the Food and Drug Administration.

In all, 15 state legislatures have passed bills raising the age to 21 as of May 1. Twelve have enacted those laws and three are awaiting a governor’s final approval, according to the Campaign for Tobacco-Free Kids. More than 450 localities have passed similar laws as well.

Even the federal government is getting involved. Sen. Sherrod Brown, D-Ohio, has co-sponsored a bill that would raise the tobacco age to 21. And Senate Majority Leader Mitch McConnell, a Kentucky Republican who counts the tobacco industry as a major force in his state, signaled he, too, plans to put a bill on the Senate floor that would increase the purchase age to 21.

Get the news delivered to your inbox: Sign up for our politics newsletter

The FDA, meanwhile, recently closed a comment period on regulations that would require flavored tobacco products to be stocked in age-restricted sections of retail stores.

The products have become omnipresent in high schools, where kids sneak hits off such popular products as Juul all day long. The products are largely odorless and easy to hide. Some companies have gone so far as to sell hoodies or backpacks designed to allow e-cigarette users to stealthily take a hit. To a less street-smart parent, the vaping devices might look like a USB device.

Marketed as a safer alternative to cigarettes, the devices were initially targeted at adults who were trying to quit cigarettes. But critics say they’ve evolved into a lure aimed at creating a new generation of nicotine addicts.

“This is a huge public health concern,” said Sarah Denny, attending physician in the Division of Emergency Medicine at Nationwide Children’s Hospital. “Nicotine is highly addictive — especially in the developing brain of a teenager.”

Linda Richter, director of policy research and analysis for the Center on Addiction, said the dosage is far higher — one pod is the equivalent of a pack of cigarettes’ worth of nicotine.

“Kids are using it basically all day long,” she said. “The amount of nicotine they’re ingesting is huge.”

Prolonged vaping, she said, can affect memory and cognition, making kids more irritable and limiting their ability to concentrate. And because the doses are so high, it’s all the more difficult to get them to quit. Nicotine patches and gum, she said, do little to satisfy the appetite of teenagers addicted to sky-high doses of nicotine.

They’re even more harmful to small children. Henry Spiller, director of the Central Ohio Poison Center, said that nationally two children have died from ingesting the products over the past five years.

Nicotine, he said, is classified as a nerve poison. Up until 1980, it was a registered pesticide.

“For little kids, because of two things — the small body weight and the high amount of nicotine — they can get in trouble pretty quickly,” he said.

The growing movement to raise the legal age for tobacco purchase to 21 is one of a handful of efforts that anti-tobacco groups are using to stem the epidemic.

John Schachter, director of state communication for the Campaign for Tobacco-Free Kids, said that while there’s been clear momentum to raise the tobacco age to 21, the tobacco industry has also tried to work that change to their advantage.

He said the e-cigarette industry has largely backed raising the age but has worked for laws that include few enforcement mechanisms, or for exemptions that effectively keep states from passing any other laws that would hurt their industry.

“We’re seeing in more and more states where the industry is getting involved and pushing bills that are not very good,” Schachter said. “They’re trying to get the benefit, saying, ‘See, we support raising the age; we’re good corporate citizens,’ but they’re actually supporting bad bills.”

Raising the age alone, he said, won’t do much to stem what has become an epidemic. Instead, Schachter said, there needs to be provisions to enforce the law that would put retailers at risk if they sell the products to minors.

Kip Greenhill, president of Upper Arlington City Council and a former high school principal, agreed that enforcement is the next frontier in the push to stop young people from becoming addicted to nicotine.

In 2015, Upper Arlington became the first city in the state to raise the age to buy tobacco to 21. The suburb recently joined a growing group of central Ohio cities — such as Grove City, Westerville and Dublin — banning tobacco use in public parks.

While the ultimate goal is preventing young people from becoming addicted to nicotine, Greenhill said he doesn't believe ticketing a 19-year-old, for example, is the best way to reduce use. Education is important, too, but it's not enough, he said.

"The next step has got to be enforcement against the distributors, the retail outlets," Greenhill said. "We’re going to have to go to a system similar to what we have with alcohol, where the health department is involved with the enforcement of these ordinances."

Richter said raising taxes on the products wouldn’t hurt, either.

“A lot of research shows teenagers and young adults are especially price sensitive,” she said. “When you raise the price of alcohol and tobacco products, you see a real decline in kids buying these products.”

Schachter said he also supports the idea of banning flavors that clearly market to the young. Former FDA Commissioner Scott Gottlieb had threatened to ban flavors if the industry didn’t work to curb the youth epidemic. For its part, Juul, which controls 75% of the market, has stopped selling fruity flavors in retail stores, opting only to sell them online, Richter said.

Gregory Conley, president of the American Vaping Association, an advocacy group for e-cigarettes, said that while his organization doesn’t love the idea of raising the legal age of tobacco purchase to 21, “There are far worse proposals in the world than tobacco 21.”

Still, he said, his organization will only back it if existing 18 to 21 year olds are grandfathered into being able to use the products legally.

One thing they’ll fight, he said, is any effort to ban the flavors. “Flavors are very important to smokers looking to quit,” he said.

Even raising the age, Conley said, won’t stop youth who are determined to vape.

“The reality is, just as with alcohol, cigarettes and marijuana, if youth are determined to get their hands on it, they will get their hands on it,” he said. “Regardless of what you try to do.”

Dispatch staff reporter Kevin Stankiewicz contributed to this story.

jwehrman@dispatch.com

@jessicawehrman

Never miss a story

Choose the plan that's right for you.
Digital access or digital and print delivery.